Tag Archives: Babies First Lactation and Education

Dressed to Deliver Questions and Answers

Question #1 How to increase supply?

The best way to increase supply is frequent, effective removal of milk from the breast.  When concerned about milk supply I cannot stress enough the importance of checking in with a Lactation Consultant.  They can do a complete assessment on Mom and Baby to see if there is something that needs improving; often a Mom will feel like she has low milk supply due to normal changes during breastfeeding (supply regulation, cluster feeding, fussy evenings, growth spurts etc).  Baby may need a better position or latch, they may have a tongue tie or lip tie that is restricting their movement and suction, or maybe the baby has been put on a schedule or timed feeds.   Frequent removal of milk from the breast is key in establishing supply or increasing it.  Our breasts have a protein in them that signal our brains when our breast is full of milk to slow down production.  So if the milk is not removed frequently our brain gets the signal that the milk is not wanted and slows down production.  Increasing removal of milk from the breast is often all that is needed to boost supply.

Feedback Inhibitor of Lactation

Supplementing leads to less stimulation and removal of milk from your breast, which will drop supply.  So if supplementing, ensure you are supported by a Lactation Consultant.

Are you eating enough?  Often a Mom will forget to care for herself in those early weeks or maybe she is watching what see eats.  Not eating enough can drop supply.  So be careful you are not cutting out too many calories.  Ideally do not drop below 1800 calories per day.  Ensure you stay hydrated by drinking to thirst.

Have you started a new medication that may be contributing to lower supply?  Many of the birth control options offered to new Moms are safe to take while nursing but may have the negative impact of decreasing supply.

Some foods that have shown to be beneficial for breast milk supply are: Fennel, oatmeal, carrot, beets, yams, alfalfa, dark green leafy vegetables, nuts, healthy fats, non- alcoholic beer, garlic, ginger, oats, brewers yeast, green papaya, red raspberry leaf tea, goat’s rue.

There are herbs that can increase milk supply.  Two of the most commonly recommended herbs are Fennugreek and Blessed Thistle.  You can read more about them here: http://www.breastfeedinginc.ca/content.php?pagename=doc-HRMS

In Canada one of the commonly prescribed medications to increase milk supply is Domperidone.  I recommend trying the above methods first.  You can read more about this medication here: http://www.breastfeedinginc.ca/content.php?pagename=doc-DGS

Eating the supply increasing foods, taking the herbs and/or prescription medication will not work to increase supply if you are not frequently and effectively removing milk from the breast.

Question #2 Teething and Breastfeeding

There were a few questions on teething discomfort.  I have a blog specifically on this subject.  It should answer all the questions on teething related breastfeeding problems.  https://babiesfirstlactation.wordpress.com/2013/09/26/dont-bite-the-boob-that-feeds-you/

Question #3 How can I have a better experience with breastfeeding my second time around? 

My biggest recommendation is to consult with a Lactation Consultant prior to delivery to discuss what happened last time and suggestions for your new little one.  Here is my blog on “Putting your best breast forward.”  I hope the tips in there are helpful.

Question #4 What do I do when the Dr. says we need to supplement with formula?

Doctors vary greatly in their knowledge and support of breastfeeding.  I strongly encourage you to seek help from a Lactation Consultant.  They can assess the situation and help improve the milk intake at the breast.  If supplementing is necessary it is important that the Mom is pumping to tell her body to make more milk and that you are supplementing safe amounts and not over feeding.  Supplementing, if needed, should be short term if the goal is to return to just breast.  A LC can help you return to exclusive breastfeeding and help with weight gain.  Here is my blog which touches on supplementing.  https://babiesfirstlactation.wordpress.com/2013/08/09/the-newborns-stomach/

Question #5 How can I get my baby who spent 3 weeks in the NICU to transition from bottle feeding to breastfeeding?

I know I sound like a broken record here…but seeing a Lactation consultant will help with hands on support.  Provide your little one with practice at the breast.  They often will be more patient breastfeeding if they aren’t overly hungry, so either, offer the breast before they reach their FEED ME NOW phase of hunger,  let them have part their bottle then try the breast or allow them practice time after a feed or in between feeds.  When latching make it easier on their little mouths by sandwiching your breast.  You can watch more on this technique in this video from Standford Univeristy:  (skip the first 5 minutes) http://newborns.stanford.edu/Breastfeeding/FifteenMinuteHelper.html  Preemies will often take the breast easier using a nipple shield- although I encourage you to consult with a lactation consultant before introducing to check sizing and recommended use.  Lots of skin to skin snuggles is beneficial for the baby and breastfeeding and for you and your milk supply.  So snuggle, snuggle, snuggle!

I hope I helped answer your questions.  Please don’t hesitate to send me a message on my Babies First Lactation and Education facebook page.  I’d be glad to explain anything further, help in person if needed or help you find support in your area.  I also offer online/phone consultations for anyone outside of my York Region area.

Thank you to Dressed to Deliver Birthing Gowns & Nursing Wraps for hosting this great contest and the breastfeeding question session tonight!  Have you entered the great contest?  Over $400.00 in prizes.  http://tinyurl.com/n5qoayb

Katie Wickham RN, BScN, IBCLC

http://www.babiesfirstlactation.com

info@babiesfirstlactation.com

 

 

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Gnawrome Giveaway

I love hearing of other Mom’s designing a business they are passionate about.  When Laila from Gnawrome contacted me to share her Organic Muslin Cotton swaddling blankets, I was very excited.

It was perfect timing as I LOVE muslin cotton and I just happen to have two of my close girlfriends give birth to new additions in the last month.  I couldn’t wait to purchase blankets for their new little ones.  I received the blankets this week and absolutely love them.

BENEFITS OF MUSLIN

Breathable

Muslin cotton is a woven fabric which makes it very lightweight and breathable.  This helps the baby to regulate its own body temperature and prevents the baby from overheating.

Stretchy

Due to the gauze-like texture, muslin cotton swaddling blankets have a certain degree of elasticity.  This allows the baby to have some amount of flexibility, yet still maintains a snug, cozy feeling.

Softness

An added bonus about muslin cotton is that the material gets softer and softer with each wash.

Show Gnawrome some love on their new facebook page.

Now you have a chance to win one of Gnawrome’s amazing blankets.  If you are a Canadian Resident, have ‘liked’ the Babies First Lactation and Education facebook page and ‘liked’ Gnawrome  facebook page you will qualify for the draw.

Simply enter here:

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Katie Wickham RN BScN, IBCLC

http://www.babiesfirstlactation.com

info@babiesfirstlactation.com

https://www.facebook.com/BabiesFirstLactationAndEducation

Why I love what I do…

thank-you1

Tonight I received a beautiful, thoughtful thank you note from a client.  I love that I get make breastfeeding easier and more enjoyable for families.  I love that I get to meet so many adorable babies.  I love that I get to work along side Mothers;  Mothers that are frustrated, hopeful, dedicated, and powerful.  When I leave a house after a consult and I can see the relief on that new families face, or I get an update saying that breastfeeding is going well, or that they have reached their goal… it is so rewarding!  So thank you to all the families that welcome me into their homes, thank you to all the sweet babies for being born, and thank you to my Amazing clients!  Thank you to the special client below for the thoughtful thank you, this quote is my favourite “Thank you for coming into my life and helping me with one of the hardest, most wonderful things I have ever done.”

“I just wanted to send you an email thanking you for all the support over the past year. ‘J’ celebrated his 1st birthday in February- and he is a healthy, breast-fed baby because of you. When I reflect back to when I was pregnant I told myself that I would breastfeed for a few months, because I thought it was going to be weird to have a baby stuck to my boob all the time. Then when I had him, and I realized how hard it was to breast feed, I told myself 4 months then I will stop…that’s if I made it that far. 

When I called you, I had had enough of breast feeding, but I wasn’t ready to give up, and then you came over and were amazing. You put everything into perspective, you gave me the guidance I needed, you were always there when I had a question/concern.

I am so happy that I was able to call upon you! Because of you, ‘J’ has been a happy breastfed baby for the past year, because of you, I haven’t dumped hundreds of dollars towards buying formula, he’s so healthy, has never really gotten sick, apart from a common cold, and if he did he would bounce back quickly. We have this amazing bond, which I will cherish forever. I am so lucky to have had this experience, and I thank you and your support. This must be a passion of yours, because that would explain the perfectionism in your work. 

Thank you for coming into my life and helping me with one of the hardest, most wonderful things I have ever done. ~Kiddy”

THANK YOU!

Katie Wickham RN BScN IBCLC

www.babiesfirstlactation.com

https://www.facebook.com/BabiesFirstLactationAndEducation

Watch the Baby

How long to feed baby picture.

How long to feed baby picture.

Something I see new Moms and Dads struggle with is how long a baby needs to feed at the breast to be full, satisfied and thrive.  I have heard all different numbers from my clients: 10 minutes each side, 20 minutes each side, 30 minutes one side.  None of these times are correct for all babies; no one time fits all.  Just like adults, each baby needs a different amount of time to eat.  When I sit down to eat with friends and family, we all finish at different times; babies are the same.  Timing feeds is misleading: it rarely provides an accurate measure of how much baby is taking in.  If we were to take two three-day old babies and measure how much they had eaten during a 15-minute breast feed, one could take in 5ml and the other could take in 35ml; if we cut off the first baby at 15 minutes, he could be underfed.  Timing also takes the focus of your baby and learning to watch/listen to them and places it on numbers which can lead to more stress.

One of the most common reasons I am called in for in-home consultations is high weight loss in the first few weeks and/or a baby having trouble gaining weight by breastfeeding.  I have seen Moms use the knowledge they were able to retain from their whirlwind visit to their Hospital for delivery, and stop a baby mid-feed at the 10- or 15-minute mark to burp the baby and switch sides.  I have even seen a Mother set a 10-minute timer so she would remember to switch sides.  Following the clock can lead you to cut your baby’s feed short.  You may be stopping them when they were just getting in to a good suck-and-swallow pattern, or you may even be limiting their ability to take in the fatty rich milk.

Watching your baby for signs of satisfaction is a much more accurate way to gauge your baby’s satiety.  Watch that baby has had a good, sustained suck-and-swallow pattern, and is not sleeping on the breast.  Watch baby for a relaxed arm; a newborn’s arm will start a feed flexed tightly with a clenched fist, a “chicken wing”.  Over the course of a good feed, your baby will slow down their sucking/swallowing pattern, relax their arm and fist, and may even fall off the breast with a relaxed open mouth; this tells you Baby is full and happy.  Once your baby gets in to this more relaxed state on the breast you can help them by performing breast compressions- ‘squeeze your breast-hold your hand their- then release the squeeze’ repeat a couple of these in a row.  Watch to see if your baby increases the sucking and swallowing.  If not you can sit your baby up and burp baby, mostly to wake so you can offer the other breast.  Offering both breasts in the beginning allows baby to take in more milk, practice breastfeeding more, and give your milk supply extra stimulation.  Your baby may not want the second breast at each feed, just like we don’t always want dessert with each meal.  Once your milk transitions, you also should feel relief in your breast from the start of a feed to the end.

Sometimes in the early days babies can be sleepy at the breast you can help them to stay actively feeding by using breast compressions and switching breasts- even going to each breast twice in a feeding to help them stay more awake and take in more milk.  If they are sucking and swallowing no need to switch breasts until they slow down/stop.

Watch that sweet baby; they can tell you a lot!

Katie Wickham RN BScN, IBCLC

info@babiesfirstlactation.com

www.babiesfirstlactation.com

www.facebook.com/BabiesFirstLactationAndEducation

Don’t Bite the Boob that Feeds You!

baby teeth

Don’t Bite the Boob that Feeds You!

“My son bit me last night; I guess it’s time to wean.”

“I see teeth coming; you can’t keep breastfeeding can you?”

In most cases, Moms will see Baby’s new teeth but won’t feel them; somehow Baby knows Mom is not food to be chewed.  But then sometimes baby gets distracted, or is struggling with teething pain, or trying to be playful, or thought your reaction from the first bite was hilarious; so Baby tries again.  There is nothing funny about teeth marks on your breast!

Here are 5 steps to help prevent or stop Baby bites.

Step 1: Before a feed offer your little one your knuckle; see Baby wants to chew for teething comfort, or suck for nourishment/soothing.  If chewing, offer a cold cloth, teething toy, etc., or give pain relief of your choice if you think they need it.  Then try to Breastfeed in a little while after Baby is soothed.

Step 2: If baby is distracted or uninterested in nursing, this can lead to biting.  If distracted, try to find an environment where baby will stay focused on feeding.  If baby is uninterested in nursing, do not force baby to nurse; allow Baby some time to play and then try to offer again.

Step 3: As babies age their latch can get relaxed.  Ensure you are helping Baby to latch deeply during this biting phase: when a baby is latched deeply to the breast and actively feeding, they physically cannot bite because of the position of their jaw and tongue.  Go back to your newborn latching technique to help baby get on deeply.

Step 4: Most biting happens at the end of a feed when Baby is full and playful.  When you start seeing signs of playfulness, end the feed, early if necessary, and distract with a song or toy so Baby isn’t upset.

Step 5: If Baby bites, remove Baby immediately from the breast and place Baby on the floor as calmly as possible and say something like “Ouch that hurts mommy, biting means no milkies”, or something along those lines.  Then you can try feeding again shortly. Baby learns very fast that biting means no milk. Try your best to stay calm; some babies find it hysterical when Mom’s yell, scream, or make faces, and try to get that reaction again, never realizing they are hurting Mommy; they just like the surprising reaction (some babies cry, some laugh).  When you are calm and repeat the same words each time (you hurt mommy, biting means no milkies), Baby probably won’t understand the words, but will make the association that biting means the boob is taken away and Baby goes on the floor.

Sometimes after new teeth emerge the latch feels uncomfortable.  Changing up your position can change the pressure those new teeth may put on the breast.  For the most part as your little one gets used to the new teeth the latch adjusts and becomes comfortable again.

Biting does not mean weaning.  Try following these tips to stop biting.

Consistency is the key.

Katie Wickham RN BScN, IBCLC

www.babiesfirstlactation.com

www.facebook.com/BabiesFirstLactationAndEducation

Image from dormenenem.com

The Newborn’s Stomach

I see many new families in the hospital, breastfeeding clinic, and in their homes with my private practice, and I hear many common questions.  One of the recurring themes comes across in statements like “my baby can’t be getting very much” or “my baby is feeding so frequently, I must not have milk. This cannot be normal!”  There are many charts on the Internet that show an illustration of the size of a newborn’s stomach, I felt putting these illustrations into real world sizes we can see would be helpful.

Below is an illustration I have created showing the approximate size and volume of a newborn’s stomach on day one, day three, at one week, and at one month.  Newborns’ tummies are tiny, and cannot/should not take in large volumes, so they need to feed frequently.  In the first day or two, their little tummy fills with 2-20 ml during a breastfeed, and then, snuggled in close to your warm chest and familiar heartbeat, they fall asleep.  Just as you may be drifting off to sleep or decide that you too should eat something, they start to wake up and show signs of hunger; their sweet little fists fly frantically to their mouth and their lips start smacking together.  Their little tummies have started to digest that perfect amount of colostrum, and they are starting to get hungry again.  A newborn baby feeds 8-12+ times in 24 hours, which means they will be feeding about every 1-3 hours.  After the first 24 hours and for the first week or two the baby should feed the minimum of 8 times in 24 hours to ensure they stay hydrated (shown by pees and poops), assist with things like jaundice and weight loss/gain, establish Mom’s milk supply properly and get lots of practice at the art of breastfeeding.

They often cluster feeds together; this means your precious little one may breastfeed for 45 minutes then fall asleep, then wake 30 minutes later and feed for another 30 minutes, and fall asleep.  The next feed may happen 2 hours later, then 3 hours after that, then an hour later… I’m sure you get the idea; there is no set schedule.  This is the best way to establish a healthy milk supply and to allow baby to control when they eat and how much.  You can not breastfeed your baby too much, but you can breastfeed them too little.

Many families feel the need to supplement their baby; maybe they are concerned with the frequent feedings, or feeling pressured from their doctor or family.  I often hear my clients comment that they hear their well-meaning family members say “The baby is crying again, she must be hungry” or “The baby is fussing, are you sure you have milk?” or “the baby just ate an hour ago, you must not have enough if he is hungry already.”  This can create, or further feed the insecurity a new mother may already be feeling, and often leads to unnecessary supplementation.  Some families feel they need to supplement due to pressure from the Doctor, and other families are supplementing for legitimate medical reasons (these reasons should be clearly communicated to you).  When you are supplementing it is crucial that you keep in mind how small those little tummies are.  If you supplement too much this will cause baby to sleep longer and feed less frequently and any time they are supplemented away from the breast you lose the stimulation  and removal of milk needed to signal your body to make more milk; this will directly impact your milk supply.  If you are supplementing always seek guidance from an expert in feeding- a board certified lactation consultant (IBCLC) will help guide you through how to supplement, how to protect your supply while supplementing and how to wean the supplements when the time is right.  Every baby is different and the size of your baby can impact how much they require/can take in by supplement.  Small term/preterm babies will often have trouble taking in the same volume as an 11lb newborn baby.  Seeking support will help customize supplementing based on your unique situation.

Understanding the size of your Baby’s stomach, the average volume taken in during a breastfeed and typical newborn feeding frequency can help alleviate some anxiety a mother feels when she is trusting her body to nourish her child.  Newborns are only this tiny for a short time, those stomachs grow quickly and they get more efficient at breastfeeding which means breastfeeding sessions become less frequent and shorter.  For now enjoy those snuggles, and feel encouraged that your baby is feeding frequently and doing a fantastic job of “demanding” a healthy supply of breast milk.  The great effort you and your baby put in during the first few days establishes a solid start for a happy and healthy breastfeeding relationship.

Copyright Babies First Lactation and Education

Copyright Babies First Lactation and Education

Katie Wickham RN BScN, IBCLC

www.babiesfirstlactation.com

https://www.facebook.com/BabiesFirstLactationAndEducation

*Original image has been updated 2 times to improve clarity and quality.  This image and any others on this topic by Babies First Lactation and Education may not be altered in any way or used without permission.  For information on using this image please contact Katie at info@babiesfirstlactation.com

Breastfeeding on the Go

Breastfeeding on the Go

‘My mummy tummy is showing, can anyone see it?’  ‘Of course you pull off now to see what that noise was, I think all those parents over there saw my nipple’ ‘Here comes the waiter, is he going to ask me to leave or does he want to take my drink order?’ ‘This is great! Baby is nursing and I’m watching big sister at soccer practice!’  These may be some of the thoughts running through your head while breastfeeding in public.

I love so many things about breastfeeding; but one of my favourite things is the freedom to be on the go.  All you need is you -and your baby of course- you are good to go anywhere!  Moms should feel safe to breastfeed in public without fear of discrimination or recrimination.   Thankfully, in Canada we have a Human Rights Code that protects you as a nursing mother; you are allowed to breastfeed in public anywhere you can legally go! No one can ask you to cover up, to move somewhere more discreet, or ask you to leave.  So get out there with your baby and feel safe breastfeeding anywhere, any time.

Some Moms question how to breastfeed comfortably in public, here are my tips:

Wardrobe selection:  When looking in your closet for what to wear for the day choose something you are comfortable in.  Layering can be very helpful if you are concerned about showing your body while latching or feeding.  Wearing a nursing tank (or belly band), and a T-shirt can make latching in public easy; you lift up the shirt and still have the tank covering any post-baby tummy you want covered and the shirt can make it easy to expose as little of your breast as you choose.  Choosing an easy open nursing bra or tank will also help with a seamless latch-on.

Practice makes perfect:  Practice latching at home in a mirror, or with friends or family whom you trust to let you know what is showing.  This way you can tailor any exposure that you may be concerned about.   You are most likely to be exposed during latch-on, so if you are concerned you can turn into a wall, or use a blanket, then turn back or remove the blanket once baby is nursing comfortably.

Accessorize on the fly:  If you use a pillow while nursing at home, try using your diaper bag or a blanket to prop baby up. You can try leaning back so baby’s weight is braced on your stomach, or elevate your legs on a makeshift stool – your stroller may work well; please apply the brakes first!

All wrapped up:  Try nursing in a carrier, wrap, or sling;  It is not always easy at first but, with practice, you can perfect the art of nursing while walking.  There are a lot of videos with tips and tricks specific to your wrap or carrier available on youtube.

Relax, stay awhile:  Find a comfy spot.  Many malls, among other places, offer a “family lounge”, these can be great places to nurse comfortably.  This is not necessary though if you prefer not to; remember that you can nurse anywhere you are comfortable.

To cover or not to cover:  Using a cover is a personal preference.  Some Moms find it awkward or difficult to latch baby while covered.  Some babies hate being under the cover and refuse to eat while under it.  Some Moms will tell you it draws more attention to them verses nursing without it.  There are many different covers out there, one that I absolutely love is the Booby Trapper (http://www.boobytrapper.ca)  It allows you to fully visualize baby, the cover stays put without collapsing on baby, which can frustrate the little ones, and it comes in some lovely patterns.  It is a great Canadian company and I love them for joining me with a giveaway for my (and their) lovely fans.  (See the contest below)

Always remember: there is no right or wrong way to breastfeed in public and no one can ask you to stop.  Over time you will find you get more comfortable with nourishing your baby on the go!

How do you breastfeed in public?  What makes it easier for you?  Do you have some words of encouragement for nervous Moms-on-the-go?

I hope these tips help!

Katie Wickham RN BScN IBCLC

www.babiesfirstlactation.com

https://www.facebook.com/BabiesFirstLactationAndEducation

Enter to win a free Booby Trapper http://bit.ly/YeYJ5u